Georges Henry Mombrun, LCSW, LCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00326700 Issued in NJ

Practice address

560 Morris St
Orange, NJ 07050-1112

Phone

(973) 592-9836

NPI assigned

Jul 12, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1285368746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 MORRIS ST",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070501112",
            "telephone_number": "973-592-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 MORRIS ST",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070501112",
            "telephone_number": "973-592-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMBRUN",
        "first_name": "GEORGES",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05967900",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00326700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELF-ISSUED",
            "identifier": "093201",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josephine Adel Mitchell
• Adam Mohammed
• Fabiona Moise
• Erika Lissette Mojica
• Emily Molina, MSW, LSW
• Adriana Montero Vallejo
• Jestina Mae Morgan
• Morris Podiatry Associates, PA
• Hawwa Muhammad
• Ziyadah N Muhammad

• Addiction (Substance Use Disorder) Counselor in Orange, NJ
• Providers in Orange, NJ by specialty
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.